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11 <br /> JUN 16 2000 11 : 54RM HPxRSERJET 3200 <br /> • p. 2 <br /> > 182695 . 09:07 2094 . PAGE ' <br /> MT OR REPAIR <br /> Site map enclosed YES I1 NO <br /> 2. . Spec sheets attach <br /> ad for equipment to b6 installed YES NO[p <br /> 3. Description of worts to be com leted: <br /> 4• Description of equipment to be used: <br /> v ,` G <br /> 5. All equipment is State certitled or lrppro*. YES NO[[ <br /> 6• DaoontaminaQon Procedures: <br /> a. Will piping be decontaminated prior to removal? <br /> YES U ,NO [� . <br /> b. Identify contractor pe rming dec�ontemination: <br /> 5 ^; Name <br /> a hone( 1 <br /> Address <br /> city <br /> �p <br /> c. Describe method to be used for ntamination: <br /> a r d. Describe how rinsete mated <br /> at Nd beatwed oMlte prior to manifesting offsite: <br /> s?' a Rinsate Hauler and perrnMed Onto Wage& Disposal Facility: <br /> Hauler Name Phone( ) ~ <br /> 9 <br /> W <br />